tbuckley/cabot-search huggingface dataset:
Assessment of Racial and Ethnic Differences in Oxygen Supplementation Among Patients in the Intensive Care Unit
Authors: Eric Raphael Gottlieb, Jennifer Ziegler, Katharine Morley, Barret Rush, Leo Anthony Celi
Journal: JAMA Internal Medicine (2022)

<h3>Importance</h3> Pulse oximetry (SpO<sub>2</sub>) is routinely used for transcutaneous monitoring of blood oxygenation, but it can overestimate actual oxygenation. This is more common in patients of racial and ethnic minority groups. The extent to which these discrepancies are associated with variations in treatment is not known. <h3>Objective</h3> To determine if there are racial and ethnic disparities in supplemental oxygen administration associated with inconsistent pulse oximeter performance. <h3>Design, Setting, and Participants</h3> This retrospective cohort study was based on the Medical Information Mart for Intensive Care (MIMIC)-IV critical care data set. Included patients were documented with a race and ethnicity as Asian, Black, Hispanic, or White and were admitted to the intensive care unit (ICU) for at least 12 hours before needing advanced respiratory support, if any. Oxygenation levels and nasal cannula flow rates for up to 5 days from ICU admission or until the time of intubation, noninvasive positive pressure ventilation, high-flow nasal cannula, or tracheostomy were analyzed. <h3>Main Outcomes and Measures</h3> The primary outcome was time-weighted average supplemental oxygen rate. Covariates included race and ethnicity, sex, SpO<sub>2</sub>–hemoglobin oxygen saturation discrepancy, data duration, number and timing of blood gas tests on ICU days 1 to 3, partial pressure of carbon dioxide, hemoglobin level, average respiratory rate, Elixhauser comorbidity scores, and need for vasopressors or inotropes. <h3>Results</h3> This cohort included 3069 patients (mean [SD] age, 66.9 [13.5] years; 83 were Asian, 207 were Black, 112 were Hispanic, 2667 were White). In a multivariable linear regression, Asian (coefficient, 0.602; 95% CI, 0.263 to 0.941;<i>P</i> = .001), Black (coefficient, 0.919; 95% CI, 0.698 to 1.140;<i>P</i> &lt; .001), and Hispanic (coefficient, 0.622; 95% CI, 0.329 to 0.915;<i>P</i> &lt; .001) race and ethnicity were all associated with a higher SpO<sub>2</sub>for a given hemoglobin oxygen saturation. Asian (coefficient, −0.291; 95% CI, −0.546 to −0.035;<i>P</i> = .03), Black (coefficient, −0.294; 95% CI, −0.460 to −0.128;<i>P</i> = .001), and Hispanic (coefficient, −0.242; 95% CI, −0.463 to −0.020;<i>P</i> = .03) race and ethnicity were associated with lower average oxygen delivery rates. When controlling for the discrepancy between average SpO<sub>2</sub>and average hemoglobin oxygen saturation, race and ethnicity were not associated with oxygen delivery rate. This discrepancy mediated the effect of race and ethnicity (−0.157; 95% CI, −0.250 to −0.057;<i>P</i> = .002). <h3>Conclusions and Relevance</h3> In this cohort study, Asian, Black, and Hispanic patients received less supplemental oxygen than White patients, and this was associated with differences in pulse oximeter performance, which may contribute to known race and ethnicity–based disparities in care.
HClO‐Activated Near‐Infrared Fluorogenic Aza‐BODIPY‐Bisferrocene Triad with High Turn‐on Ratio for In Vivo Biosensing
Authors: Dongrui Yin, Chenzhi Yao, Ying Chen, Zuyang He, Peng Yu, Xingwen Sun, Shangfeng Wang, Fan Zhang
Journal: Advanced Healthcare Materials (2022)

Abstract Optically monitoring hypochlorous acid (HClO) in living body favors diagnosis and study of inflammatory diseases. However, this has been hampered by limited strategies to develop highly fluorogenic tools in the deep‐penetration near‐infrared spectrum. Herein, a near‐infrared aza‐BODIPY‐bisferrocene triad Fc 2 ‐CBDP that unexpectedly achieves an exceptionally sensitive and selective fluorescence turn‐on (&gt;220‐fold) response toward HClO through single‐ferrocene oxidation and boron‐alkynyl hydrolysis cascade is reported. Mechanism insight shows that Fc 2 ‐CBDP features “enhanced charge transfer”‐caused quenching due to intramolecular bisferrocene electronic coupling, which is decoupled in the reaction with HClO. The utility of Fc 2 ‐CBDP for intracellular HClO imaging is evaluated and, more importantly, in vivo high‐contrast deep‐tissue imaging of lymphatic inflammation and colitis is realized. This work provides new insights into both HClO and ferrocene chemistry, and extends the reach of fluorogenic strategies in the near‐infrared biosensing.
Unmet Needs in Health Disparities Research—It’s Not Just About Patients
Authors: Nadine J. Barrett, Karen Bullock, Kimberly S. Johnson
Journal: JAMA Internal Medicine (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Gain of Chromosome 1q Perturbs a Competitive Endogenous RNA Network to Promote Melanoma Metastasis
Authors: Xiaonan Xu, Kaizhen Wang, Olga Vera, Akanksha Verma, Neel Jasani, Ilah Bok, Olivier Elemento, Dongliang Du, Xiaoqing Yu, Florian A. Karreth
Journal: Cancer Research (2022)

Abstract Somatic copy-number alterations (CNA) promote cancer, but the underlying driver genes may not be comprehensively identified if only the functions of the encoded proteins are considered. mRNAs can act as competitive endogenous RNAs (ceRNA), which sponge miRNAs to posttranscriptionally regulate gene expression in a protein coding–independent manner. We investigated the contribution of ceRNAs to the oncogenic effects of CNAs. Chromosome 1q gains promoted melanoma progression and metastasis at least in part through overexpression of three mRNAs with ceRNA activity: CEP170, NUCKS1, and ZC3H11A. These ceRNAs enhanced melanoma metastasis by sequestering tumor suppressor miRNAs. Orthogonal genetic assays with miRNA inhibitors and target site blockers, along with rescue experiments, demonstrated that miRNA sequestration is critical for the oncogenic effects of CEP170, NUCKS1, and ZC3H11A mRNAs. Furthermore, chromosome 1q ceRNA-mediated miRNA sequestration alleviated the repression of several prometastatic target genes. This regulatory RNA network was evident in other cancer types, suggesting chromosome 1q ceRNA deregulation as a common driver of cancer progression. Taken together, this work demonstrates that ceRNAs mediate the oncogenicity of somatic CNAs. Significance: The function of CEP170, NUCKS1, and ZC3H11A mRNAs as competitive endogenous RNAs that sequester tumor suppressor microRNAs underlies the oncogenic activity of chromosome 1q gains.
Smartphone‐Assisted Patient‐Initiated Care Versus Usual Care in Patients With Rheumatoid Arthritis and Low Disease Activity: A Randomized Controlled Trial
Authors: Bart Seppen, Jimmy Wiegel, Marieke M. ter Wee, Dirkjan van Schaardenburg, Leo D. Roorda, Michael T. Nurmohamed, Maarten Boers, Wouter H. Bos
Journal: Arthritis & Rheumatology (2022)

Objective We developed a smartphone application for patients with rheumatoid arthritis (RA) that allows them to self‐monitor their disease activity in between clinic visits by answering a weekly Routine Assessment of Patient Index Data 3. This study was undertaken to assess the safety (noninferiority in the Disease Activity Score in 28 joints using the erythrocyte sedimentation rate [DAS28‐ESR]) and efficacy (reduction in number of visits) of patient‐initiated care assisted using a smartphone app, compared to usual care. Methods A 12‐month, randomized, noninferiority clinical trial was conducted in RA patients with low disease activity and without treatment changes in the past 6 months. Patients were randomized 1:1 to either app‐supported patient‐initiated care with a scheduled follow‐up consultation after a year (app intervention group) or usual care. The coprimary outcome measures were noninferiority in terms of change in DAS28‐ESR score after 12 months and the ratio of the mean number of consultations with rheumatologists between the groups. The noninferiority limit was 0.5 difference in DAS28‐ESR between the groups. Results Of the 103 randomized patients, 102 completed the study. After a year, noninferiority in terms of the DAS28‐ESR score was established, as the 95% confidence interval (95% CI) of the mean ΔDAS28‐ESR between the groups was within the noninferiority limit: −0.04 in favor of the app intervention group (95% CI −0.39, 0.30). The number of rheumatologist consultations was significantly lower in the app intervention group compared to the usual care group (mean ± SD 1.7 ± 1.8 versus 2.8 ± 1.4; visit ratio 0.62 [95% CI 0.47, 0.81]). Conclusion Patient‐initiated care supported by smartphone self‐monitoring was noninferior to usual care in terms of the ΔDAS28‐ESR and led to a 38% reduction in rheumatologist consultations in RA patients with stable low disease activity.
Phosphatidylinositol <scp>3‐Kinase</scp> δ Deficiency Protects From Antimyeloperoxidase Vasculitis
Authors: Fernanda Flórez‐Barrós, Simon Freeley, El Li Tham, Michael G. Robson
Journal: Arthritis & Rheumatology (2022)

Objective Antineutrophil cytoplasmic antibody–associated vasculitis (AAV) is a systemic autoimmune disease in which glomerulonephritis is an important manifestation. Antibodies against myeloperoxidase (MPO) or proteinase 3 are thought to be important in pathogenesis. Phosphoinositide 3‐kinase δ (PI3Kδ) mediates a number of effects in lymphocytes, but its role in myeloid cell responses is less clear. Therefore, this study was undertaken to assess this in a preclinical model of glomerulonephritis induced by the transfer of antibodies to MPO. Methods D910A mice with inactive PI3Kδ were compared with wild‐type controls. Disease protocols allowed for a comparison of experimental groups in the setting of both mild and more severe disease. Adoptive transfer experiments were performed, with flow cytometric analysis of digested kidneys taken at the end of the experiment. Results With mild disease, D910A mice had fewer glomerular macrophages, fewer glomerular neutrophils, and reduced albuminuria compared with wild‐type controls. With more severe disease, they also had fewer glomerular crescents and lower serum creatinine levels, indicating protection from acute kidney injury. Adoptive transfer experiments showed a defect in the recruitment of D910A monocytes to the diseased kidney. Conclusion Mice with inactive PI3Kδ were protected from anti‐MPO vasculitis. This is due to cell intrinsic defect in the recruitment of monocytes to the kidney. These findings suggest that PI3Kδ is a potential therapeutic target in AAV.
IL-24 intrinsically regulates Th17 cell pathogenicity in mice
Authors: Christopher Sie, Ravi Kant, Christian Peter, Andreas Muschaweckh, Monika Pfaller, Lucy Nirschl, Helena Domínguez Moreno, Tereza Chadimová, Gildas Lepennetier, Tanja Kuhlmann, Rupert Öllinger, Thomas Engleitner, Roland Rad, Thomas Korn
Journal: The Journal of Experimental Medicine (2022)

In certain instances, Th17 responses are associated with severe immunopathology. T cell–intrinsic mechanisms that restrict pathogenic effector functions have been described for type 1 and 2 responses but are less well studied for Th17 cells. Here, we report a cell-intrinsic feedback mechanism that controls the pathogenicity of Th17 cells. Th17 cells produce IL-24, which prompts them to secrete IL-10. The IL-10–inducing function of IL-24 is independent of the cell surface receptor of IL-24 on Th17 cells. Rather, IL-24 is recruited to the inner mitochondrial membrane, where it interacts with the NADH dehydrogenase (ubiquinone) 1 α subcomplex subunit 13 (also known as Grim19), a constituent of complex I of the respiratory chain. Together, Grim19 and IL-24 promote the accumulation of STAT3 in the mitochondrial compartment. We propose that IL-24–guided mitochondrial STAT3 constitutes a rheostat to blunt extensive STAT3 deflections in the nucleus, which might then contribute to a robust IL-10 response in Th17 cells and a restriction of immunopathology in experimental autoimmune encephalomyelitis.
Association Between State Supplemental Nutrition Assistance Program Policies, Child Protective Services Involvement, and Foster Care in the US, 2004-2016
Authors: Michelle Johnson-Motoyama, Donna K. Ginther, Patricia Oslund, Lindsay Jorgenson, Yoonzie Chung, Rebecca Phillips, Oliver W. J. Beer, Starr Davis, Patricia L. Sattler
Journal: JAMA Network Open (2022)

<h3>Importance</h3> Public assistance policies may play a role in preventing child maltreatment by improving household resources among families of low incomes. The Supplemental Nutrition Assistance Program (SNAP) is one of the largest public assistance programs in the US. However, the association of state SNAP policy options to Child Protective Services (CPS) outcomes has not been rigorously examined. <h3>Objective</h3> To model the association of state SNAP policies with changes in CPS and foster care outcomes in the US over time. <h3>Design, Setting, and Participants</h3> This cohort study used panel data to examine the association between SNAP policy options and study outcomes from 2004 to 2016 for 50 US states and the District of Columbia in 2-way fixed-effects regression models. The count of SNAP policies was used as an instrument for SNAP caseloads in instrumental variables models. Data analysis was conducted in November 2021. <h3>Exposures</h3> The adoption of 1 or more state SNAP income generosity policies that improves or stabilizes household resources for SNAP participants. <h3>Main Outcomes and Measures</h3> Reports of child maltreatment accepted for CPS investigation, children in substantiated reports, and children receiving foster care services for all forms of maltreatment, and specifically for child neglect per 100 000 child population. <h3>Results</h3> The mean (SD) number of SNAP income generosity policies increased from 1.47 (0.95) in 2004 to 2.37 (0.94) in 2010, to 2.49 (0.86) in 2016 across states; the median increased from 1 to 3 (range, 0-4) over the same period. A count of state income generosity policies was associated with large reductions in reports accepted for CPS investigation (–352.6 per 100 000 children; 95% CI, –557.1 to –148.2). Income generosity policy was associated with –94.8 (95% CI, –155.6 to –34.0) fewer substantiated reports and –77.0 (95% CI, –125.4 to –28.6) fewer reports substantiated for neglect per 100 000. Each additional income generosity policy adopted by a state was associated with –45.1 (95% CI, –71.6 to –18.5) to –42.3 (95% CI, –64.8 to –19.8) fewer total foster care placements per 100 000 children. <h3>Conclusions and Relevance</h3> State SNAP policies that improve and stabilize household resources appear to be associated with reductions in CPS involvement and use of foster care. The number of policies implemented had cumulative outcomes beyond individual policy outcomes.
Analysis of Professionalism Themes Raised in Evaluations of Faculty
Authors: Janae K. Heath, Caitlin B. Clancy, C. Jessica Dine, William J. S. Pluta, Jennifer R. Kogan
Journal: JAMA Network Open (2022)

We performed a qualitative study of narrative evaluations of faculty at a single, large academic medical center, using a random sample of deidentified faculty evaluations written by medical students, residents, and fellows from July 1, 2017, to December 31, 2019.The study was deemed exempt by the University of Pennsylvania's institutional review board because it was believed to pose minimal risk to study participants.This study followed the Standards for Reporting Qualitative Research (SRQR) reporting guideline.We conducted a summative content analysis of comments, using the constant comparative method, to identify and classify professional lapses.An initial codebook was developed using prior classifications of unprofessional behavior, 1,4 with iterative revisions made by consensus at prespecified coding intervals.Comments were coded for references to unprofessional behavior and the domain(s) observed in each comment.Three coders (J.K.H., C.B.C., and J.R.K.) jointly coded an initial set of 100 comments, then independently coded 100 additional comments using Excel, version 16.16.1 (Microsoft Corporation), with subsequent group consensus.Ten percent of comments from 2017 to 2018 were triple-coded to ensure greater than 80% agreement by κ scores, and the remaining comments were coded with 5% triple-coding.We performed summary statistics to quantify the professionalism themes.Analyses were conducted from October 2021 to February 2022. ResultsA total of 15 432 evaluations were analyzed (32% of 48 384 learner evaluations) (Table 1).A total of 1004 professionalism lapses were identified within 735 evaluations with references to unprofessional behavior (5% of total evaluations).Interrater reliability was high (κ = 0.71-1.0;mean [SD], 0.87 [0.15]).Table 2 lists the themes observed.A total of 837 professionalism lapses [83%] pertained to disrespectful interactions with colleagues, coworkers, and students, whereas 86 references [9%] were related to observed interactions with patients and their families.The most common theme was emotional disrespect of the learner (279 [28%]), followed by failure to include, acknowledge, and/or validate learners (114 [11%]).Sexual harassment (18 [2%]), harassment based on race or ethnicity (8 [0.8%]) or sexual orientation (3 [0.3%]), and physical disrespect (7 [0.7%]) were less common.
Application of Video-Based Deep Learning for Early Diagnosis of Neurological Disorders
Authors: Elie Massaad, John H. Shin
Journal: JAMA Network Open (2022)

Daniel Groos, MS; Lars Adde, PT, PhD; Sindre Aubert, MS; Lynn Boswell, PT, MS; Raye-Ann de Regnier, MD; Toril Fjørtoft, PT, PhD; Deborah Gaebler-Spira, MD; Andreas Haukeland, MS; Marianne Loennecken, PT; Michael Msall, MD; Unn Inger Möinichen, PT, MS; Aurelie Pascal, PT, PhD; Colleen Peyton, PT, DPT; Heri Ramampiaro, PhD; Michael D. Schreiber, MD; Inger Elisabeth Silberg, MD; Nils Thomas Songstad, MD, PhD; Niranjan Thomas, MD, PhD; Christine Van den Broeck, PT, PhD; Gunn Kristin Øberg, PT, PhD; Espen A.F. Ihlen, PhD; Ragnhild Støen, MD, PhD
Repaving the Pathway to Prevent the Loss of Students With Marginalized Identities—Medical Student Attrition
Authors: Monica L. Lypson, Cristina M. Gonzalez, Paula Y. Thompson
Journal: JAMA Internal Medicine (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Protecting Children in Social Media
Authors: David H. Jernigan
Journal: JAMA Pediatrics (2022)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Pediatrics HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Pediatrics journal
Long-Term Services and Supports for Older Adults: A Position Paper From the American College of Physicians
Authors: Ryan Crowley, Omar Atiq, David Hilden, Micah W. Beachy, Heather C. Brislen, William A. Curry, Lee S. Engel, Matthew Hollon, Suja M. Mathew, Molly Southworth, Michael J. Tan, Pranav Mellacheruvu, Christiana S. Shoushtari, Ankita Sagar, Micah W. Beachy, Heather C. Brislen, William A. Curry, Lee S. Engel, Matthew Hollon, Suja M. Mathew, Molly Southworth, Michael J. Tan, Pranav Mellacheruvu, Christiana S. Shoushtari, Ankita Sagar, Omar Atiq, David Hilden
Journal: Annals of Internal Medicine (2022)

The number of Americans aged 65 years or older is expected to increase in the coming decades. Because the risk for disability increases with age, more persons will need long-term services and supports (LTSS) to help with bathing, eating, dressing, and other everyday tasks. Long-term services and supports are delivered in nursing homes, assisted living facilities, the person's home, and other settings. However, the LTSS sector faces several challenges, including keeping patients and staff safe during the COVID-19 pandemic, workforce shortages, quality problems, and fragmented coverage options. In this position paper, the American College of Physicians offers policy recommendations on LTSS coverage, financing, workforce, safety and quality, and emergency preparedness and calls on policymakers and other stakeholders to reform and improve the LTSS sector so that care is high quality, accessible, equitable, and affordable.
Differences Among Racial and Ethnic Minority Groups in the Unmet Existential and Supportive Care Needs of People Receiving Dialysis
Authors: Catherine R. Butler, Rashmi K. Sharma, Nwamaka D. Eneanya, Gwen M. Bernacki, Jasleen K. Ghuman, J. Randall Curtis, Ann M. O’Hare
Journal: JAMA Internal Medicine (2022)

This cohort study examines differences regarding existential and supportive care needs for patients with kidney disease between individuals of racial and ethnic minority groups compared with White individuals.